PET/MR study of Metastatic Lymph Nodes in Head and Neck Cancer

头颈癌转移性淋巴结的 PET/MR 研究

• 批准号: 8768574
• 负责人: Sungheon Gene Kim
• 金额: $ 35.17万
• 依托单位: NEW YORK UNIVERSITY SCHOOL OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-09-01 至 2016-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8768574
• 关键词: Aftercare; Blood Vessels; Carrier Proteins; Cell membrane; Cells; Contrast Media; Data; Detection; Diagnosis; Diagnostic Imaging; Dissection; Drug Kinetics; Evaluation; Excision; Gadolinium; Glucose Transporter; Goals; Head and Neck Cancer; Immunohistochemistry; Intracellular Space; Joints; Kinetics; Knowledge; Lymph Node Dissections; Lymphatic Metastasis; MRI Scans; Magnetic Resonance Imaging; Malignant Neoplasms; Measures; Methods; Modality; Modeling; Neoplasm Metastasis; Nodal; Non-Invasive Cancer Detection; Operative Surgical Procedures; Pathology; Patient Schedules; Patients; Phase; Phosphorylation; Physiological; Positron-Emission Tomography; Property; Reference Standards; Research; Residual Tumors; Role; Scanning; Schedule; Signal Transduction; Specificity; Staining method; Stains; Techniques; Testing; Therapy Evaluation; Tracer; United States; Validation; Vascular System; Visit; advanced disease; base; cancer type; fluorodeoxyglucose; fluorodeoxyglucose positron emission tomography; gadolinium oxide; glucose metabolism; glucose uptake; head and neck cancer patient; imaging modality; lymph nodes; neoplastic cell; public health relevance; response; treatment planning; tumor; tumor microenvironment

DESCRIPTION (provided by applicant): Head and neck cancers represent approximately 3% of invasive cancers (about 55,000 patients) diagnosed annually in the United States. Approximately two thirds of all patients present with locally advanced disease. The best chance for cure of head and neck cancer is typically aggressive treatment at initial presentation including complete lymph node dissection. Accurate identification of nodal metastases is a crucial step for treatment planning and evaluation of therapy response. Knowledge of the extent of nodal metastases prior to surgery can help avoid unnecessary removal of lymph nodes. However, current imaging methods are not adequate for reliable assessment of metastatic nodes in both diagnostic imaging and post-treatment evaluation. The overarching goal of this study is to develop PET/MR techniques for accurate, non-invasive detection of nodal metastases for treatment planning and assessment of residual tumor in metastatic nodes after treatment, such that unnecessary removal of nodes can be minimized. A state-of-the-art PET/MR scanner will be utilized to acquire PET and MRI data simultaneously within one session. Our central hypothesis is that a combined model of FDG-PET and DCE-MRI measures can detect metastatic nodes more accurately than FDG-PET or DCE-MRI alone. This hypothesis can be best tested when both PET and MRI scans are simultaneously conducted in one setting, as it can minimize any physiological difference in tumor microenvironment between separate PET and MRI scans, in addition to the benefit of fewer visits for the participating patients. We propose to conduct dynamic PET/MR scans with head and neck cancer patients (n=50) scheduled for full node dissection surgery so that pathological evaluation of dissected nodes can be used as the reference standard to evaluate the accuracy of PET/MR measures. During the surgery, the level of nodes will be recorded for level- to-level comparison between PET/MR and pathology evaluation. The first phase of the study (Aim 1) is to assess the extent of which a combination of FDG-PET and DCE- MRI measures can identify metastatic nodes more accurately than FDG-PET or DCE-MRI alone. Aim 2 is to determine the association between the kinetic parameters of FDG-PET and DCE-MRI and investigate the complimentary roles of FDG-PET and DCE-MRI parameters. Transport rate constant from the proposed joint analysis will be compared with the expression level of glucose transporters on the tumor cell membrane using immunohistochemistry staining. If successful, the research in this proposal will establish a more reliable and accurate method to non-invasively detect metastatic lymph nodes in head and neck cancer. This method can then also be extended to evaluating nodal metastasis for diagnosis and post-treatment evaluation in other types of cancer.

描述（由申请人提供）：头颈癌约占美国每年诊断的侵袭性癌症（约 55,000 名患者）的 3%。大约三分之二的患者患有局部晚期疾病。治愈头颈癌的最佳机会通常是在初次就诊时进行积极治疗，包括完整的淋巴结清扫术。准确识别淋巴结转移是治疗计划和治疗反应评估的关键步骤。手术前了解淋巴结转移的范围有助于避免不必要的淋巴结切除。然而，当前的成像方法不足以在诊断成像和治疗后评估中可靠地评估转移淋巴结。本研究的总体目标是开发 PET/MR 技术，用于准确、无创地检测淋巴结转移，以制定治疗计划并评估治疗后转移淋巴结中的残留肿瘤，从而最大限度地减少不必要的淋巴结切除。将利用最先进的 PET/MR 扫描仪在一个疗程中同时采集 PET 和 MRI 数据。我们的中心假设是，FDG-PET 和 DCE-MRI 测量的组合模型可以比单独使用 FDG-PET 或 DCE-MRI 更准确地检测转移淋巴结。当 PET 和 MRI 扫描在一个环境中同时进行时，这一假设可以得到最好的检验，因为它可以最大限度地减少单独 PET 和 MRI 扫描之间肿瘤微环境的任何生理差异，此外还有减少参与患者就诊的好处。我们建议对计划进行全淋巴结清扫手术的头颈癌患者（n=50）进行动态PET/MR扫描，以便将清扫淋巴结的病理学评估作为评估PET/MR测量准确性的参考标准。手术过程中，记录淋巴结的水平，用于PET/MR和病理评估之间的逐级比较。该研究的第一阶段（目标 1）是评估 FDG-PET 和 DCE-MRI 测量相结合比单独使用 FDG-PET 或 DCE-MRI 更准确地识别转移淋巴结的程度。目标 2 是确定 FDG-PET 和 DCE-MRI 动力学参数之间的关联，并研究 FDG-PET 和 DCE-MRI 参数的互补作用。将使用免疫组织化学染色将来自所提出的联合分析的转运速率常数与肿瘤细胞膜上葡萄糖转运蛋白的表达水平进行比较。如果成功，该提案中的研究将建立一种更可靠、更准确的方法来非侵入性检测头颈癌的转移淋巴结。该方法还可以扩展到评估淋巴结转移，以用于其他类型癌症的诊断和治疗后评估。